This Week in Human Rights News

World Mental Health Day

October 10 is World Mental Health Day. This year, the jfa editorial board examines human rights violations against people with mental disabilities, the state of mental health during Covid-19, and how mental health is an essential human right.

While the conversation around mental health is gradually changing, it continues to be plagued by stigma, taboo and general lack of awareness.  

Globally, people with mental health conditions, users of mental health services, or persons with psychosocial conditions experience discrimination, physical and sexual abuse, violations of economic, social and other rights, and the denial of autonomy and legal capacity. One such example of abuse is shackling. 

On October 6, 2020, HRW released a report revealing that hundreds of thousands of people with mental health conditions are shackled, or have been shackled at one point in their life, around the world. HRW found evidence of shackling across 60 countries in Asia, Africa, Europe, the Middle East, and the Americas. 

What is shackling?

Shackling is when a person is chained or locked in a confined space. People with mental health conditions are often shackled by families in their own homes or in overcrowded institutions, against their will, due to widespread stigma and a lack of mental health services. Some are shackled for days, months and even years. 

While the conditions and reasons for shackling vary, one thing is clear: those being shackled live in extremely unsanitary and degrading conditions - often forced to eat, sleep, urinate, and defecate in the same space - are experiencing numerous violations of their human rights.

Paul, who was interviewed by HRW in Kisumu, Kenya, described his conditions:

“I’ve been chained for five years. The chain is so heavy. It doesn’t feel right; it makes me sad. I stay in a small room with seven men. I’m not allowed to wear clothes, only underwear. I eat porridge in the morning and if I’m lucky, I find bread at night, but not every night.”

Even though shackling is practiced around the world, it remains invisible, often due to shame and stigma. Due to lack of data and awareness, tackling the issue of shackling on a national and global level is difficult.

Mental health is a human right

The right to health contains freedoms: the right to be free from non-consensual medical treatment; and entitlements: such as the right to a health system that provides equal access to quality treatment.

A 2017 UN mental health and human rights report writes that the core obligations to right to health apply as much to mental health as they do to physical health, from non-discrimination, to access to health facilities, adequate food, housing, and sanitation. The promotion of mental health has also been explicitly included in the United Nations' 2015–30 Sustainable Development Goals (SDGs): SDG 3.4 addresses prevention and treatment, and promotes mental health and well-being.

The right to the highest attainable standard of physical and mental health is a fundamental human right. 

However, mental health services remain severely underfunded. The World Health Organisation (WHO) and Human Rights Watch (HRW) report that globally, governments spend less than 2% of their health budgets on mental health, a concerning statistic given that an estimated 1 in 10 people worldwide are living with a mental health condition.  

Mental health in a pandemic

Covid-19 has resulted in physical and social isolation, closure of schools, and widespread job losses. Misuse of substances, particularly alcohol, is rising. Frontline workers are experiencing increased workload and trauma, making them susceptible to stress, burnout, depression, and post-traumatic stress disorder (PTSD).

According to a recent WHO survey conducted in 130 countries, the Covid-19 pandemic has disrupted or halted critical mental health services in 93% of countries worldwide while the demand for mental health is increasing, reinforcing the urgent need for increased funding.